Individual
DR. FUMIO SHIBATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2200 LARKSPUR LANDING CIRCLE, SUITE 103, LARKSPUR, CA 94939
(415) 608-7823
Mailing address
PO BOX 4447, SAN RAFAEL, CA 94913-4447
(415) 608-7823
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
16047
CA
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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